Becker's Hospital Review

33 CFO / FINANCE KentuckyOne Health Transfers Ownership of Clinic for $0 By Alyssa Rege R ather than permanently shutter one of its clinics, Louisville-based KentuckyOne Health transferred ownership of Westside Medi- cal Center Primary Care Clinic to Family Health Centers, both in Louisville, at no charge, according to Louisville Business First. KentuckyOne officials said they decided in March to close the facility in August as part of the health system's plan to divest a portion of its assets in Louisville, the report states. Officials also said the clinic had experienced declining patient volumes for the past several years. However, community leaders voiced their opposition to the closing. To satisfy local officials, KentuckyOne transferred ownership of the facility to nonprofit Family Health Centers. Officials temporarily closed the clinic Aug. 31 for repairs and renova- tions. The facility will reopen Nov. 6 as Family Health Centers-Westside. "We welcome the opportunity to grow our services in West Louis- ville, where there is a significant need for affordable, quality primary care services," said Bill Wagner, executive director of Family Health Centers. n Specialists Could See 16% Variability in Payments Under MIPS in 2018 By Emily Rappleye P hysician specialist Medicare Part B payment adjustments could fluctuate by up to 16 percent positively or negatively under the 2018 proposed rule for the Medicare Access and CHIP Reau- thorization Act, according to an analysis from Avalere, a Washington, D.C.-based consulting firm. If the proposed rule is approved, these payment fluctuations would occur in MACRA's Merit-based Incentive Payment System beginning in the 2018 performance year. Changes in the proposed rule would add Medicare payments for Part B drugs into the calculation for the MIPS payment adjustment, which would disproportionately affect physician specialists, according to the report. "Certain specialists administer more Part B drugs than others and, therefore, may be exposed to significant financial risk and payment swings year-over-year under the CMS proposal," John Feore, direc- tor at Avalere, said in a statement. "If the proposal is finalized, these specialists could see substantially higher payment penalties or re- wards than their counterparts who administer fewer Part B drugs." Specialists such as rheumatologists, oncologists and ophthalmolo- gists are particularly subject to greater risk due to this provision, ac- cording to Avalere. Additionally, many specialists do not qualify for participation in any Advanced Alternative Payment Models, so they will be unable to avoid the risk associated with adding drugs to the MIPS calculation. n OIG: ACOs Reduced Spending by Nearly $1B, 'Show Promise' By Emily Rappleye T he Medicare Shared Savings Program, one of Medicare's largest value-based care demonstra- tions, proved to be fairly successful over time in reducing spending and improving the quality of care, according to a report from HHS' Office of Inspector General. "While policy changes may be warranted, ACOs show promise in reducing spending and improving quality," the report reads. e report analyzes the performance of the program's 428 ACOs that participated in the pro- gram in its first three years, from 2013 to 2015. Here are the OIG's main findings. 1. Across all ACOs, the program's net reduction in Medicare spending was nearly $1 billion, compared to benchmarks. Two-thirds of the ACOs reduced spending in at least one year of the program, totaling a $3.4 billion reduction. Almost half of this was concen- trated among 36 ACOs, which generated $1.7 billion of that savings. However, the 146 ACOs that exceeded benchmark spending did so significantly. ey exceed- ed benchmarks by $2.4 billion, offsetting roughly two- thirds of the savings generated among the other ACOs. 2. ACOs improved over time. ACOs in the program for all three years were more likely to reduce spending in 2015 compared to those in the program for just one year (57 percent compared to 46 percent). e more experienced ACOs also generated greater savings — an average of $10.1 million per ACO in 2015, compared to $5.4 million per ACO among the newer ACOs. 3. Overall quality improved across the program. e average overall quality score improved from 86 in 2014 to 91 in 2015. Performance improved across 82 percent of the measures and ACOs outperformed fee-for-ser- vice providers across 81 percent of the quality mea- sures. Notable improvements were made in depression screening, fall risk screening and hospital readmis- sions. However, a handful of measures worsened, such as timely access to care and high blood pressure screen- ing and follow up. 4. e highest performers — those able to reduce av- erage spending per beneficiary on certain services by an average of $673 from 2010-2015 while improving quality — were similar in several ways. Spending was compared from 2010-2015 to see how ACOs changed since joining the program. e highest performing ACOs participated in the program all three years, had slightly larger and sicker patient populations, used more primary care and reduced inpatient care and skilled nursing facility care. n

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